This current book, the Sharira-sthana (english translation), deals with anatomy, the human body, cosmology, embryology and various other subjects.
The Sushruta Samhita is the most representative work of the Hindu system of medicine. It embraces all that can possibly appertain to the science of medicine. Susruta-samhita is recognized as the first a...

Chapter IV - The development of a fetus in the womb

Now we shall discourse on the Sharira which treats of the development of a fetus in the womb, as well as of the factors which contribute to the growth of its different bodily organs and principles (Garbha-Vyakarana-Sharira). 1.

The Pitta (fiery or thermogenic) and Sleshma (lunar principles of the body, the bodily Vayu, the three primary qualities of Sattva, Rajas, and Tamas (adhesion, cohesion and disintegration), the five sense organs, and the Self (Karma-Purusha) are the preserver of the life (Pranah) of the Fetus. 2.

Folds of Skin:—

Seven folds or layers of covering (Tvaka—skin) are formed and deposited on the rapidly transforming product of the combination of (semen) Shukra and Shonita (fertilized ovum) which have been thus charged with the individual Soul or Self in the same manner as layers (of cream) are formed and deposited on the surface of (boiling) milk.

1) Of these the first fold or layer is called Avabhasini (reflecting) as it serves to reflect all colours and is capable of being tinged with the hues of all the five material principles of the body. The thickness of this fold measures eighteen-twentieth of a Vrihi[1] (rice grain) and it is the seat of skin diseases, such as Sidhma, Padma-kantaka etc.

2) The second fold (from the surface) is called Lohita; it measures a sixteen-twentieth of a Vrihi and is the seat of such (cutaneous affections; as Tilakalaka, Nyaccha and Vyanga etc.

3) The third fold or layer is called Shveta, which measures in thickness, a twelve-twentieth of a Vrihi, and forms the seat of such diseases as Ajagalli, Carmadala, and Mashaka etc.

4) The fourth fold or layer is called Tamra measuring an eight-twentieth of a Vrihi and forms the seat of such diseases as the various kinds of Kilasa and Kushtha etc.

5) The fifth fold or layer is called Vedini, measuring in thickness a five-twentieth of a Vrihi and forms the seat of Kushtha, Visarpa, etc.

6) The sixth fold or layer is called Rohini, which is of equal thickness as a Vrihi (grain), and is the seat of Granthi, Apachi, Arvuda, Shlipada and Gala-ganda etc.

7) The seventh fold or layer is called Mansa-dhara twice a Vrihi in thickness and is the seat of Bhagandara, Vidradhi, and Arsha etc.

These dimensions should be understood to hold good of the skin of the fleshy parts of the body, and not of the skin on the forehead, or about the tips of the fingers, inasmuch as there is a surgical dictum to the effect that an incision as deep as the thickness of the thumb may be made into the region of the abdomen with the help of a Vrihi-mukha (instrument). 3.

The Kalas too number seven in all and are situated at the extreme borders (forming encasement and support) of the different fundamental principles (Dhatus) of the organism. 4.

Memorable Verses:—

As the duramen or core of a piece of wood or stem becomes exposed to view by cutting into it, so the root principles (Dhatus) of the body may be seen by removing the successive layers or tissues of its flesh. These Kalas are extensively supplied with Snayus (fibrous tissues), bathed in mucous, and encased in a membranous covering. 5-6

Mansadhara-Kala:—

Of these Kalas, the first is named Mansadhara (fascia), in the contained flesh (bodily substance of the Kala) of the Shira (veins), Snayu (fibrous tissues), Dhamani (arteries) and other Shrotas (channels; are found to spread and branch out. 7.

Memorable Verse:—As the roots and stems of a lotus plant respectively situated in the ooze and water (of a tank), do simultaneously grow and expand, so the veins etc situated in the flesh, grow and ramify. 8.

Raktadhara-Kala:—

The second Kala is called Rakta-dhara (Vascular tissue of the blood vessels etc.). The blood is contained in these inside the flesh and specially in the veins (Shira) and in such viscera of the body as the liver and spleen. 9.

Memorable Verse:—As a plant containing latex in its tissues, when injured or pricked, exudes milky juice, so blood oozes out instantaneously on the flesh of the body (supplied with the Raktadhara-kala) being injured. 10.

Medadhara-Kala:—

The third Kala is called Medadhara (adipose tissue). Meda (fat) is present (chiefly) in the abdomen of all animals, as well as in the cartilages (small bones). The fatty substance present in large bones is called Majja (marrow). 11.

Memorable Verse:—Marrow is found inside large bones, whereas a substance similar in appearance and found inside other bony structures (cartilages) should be considered as Meda, mixed with blood. The fats, present in purely muscular structures, go by the name of Vasa (muscle-fat). 12-13.

Shleshmadhara-Kala:—

The fourth Kala is called Shleshmadhara (Synovial tissues) and is present about all the bone-joints of animals. 14.

Memorable Verse:—As a wheel easily turns upon a well greased axle, so the joints moistened by the mucous (Sleshma) contained in these sacs admit of easy movements. 15.

Purishadhara-Kala:—

The fifth kala is called Purishadhara and being situated in the Kostha (abdomen) serves to separate the fecal refuse in the (Pakvashaya) lower gut (from other ingested matters). 16.

Memorable Verse:—This Kala extends about the liver, upper and lower intestines and other abdominal viscera and keeps the feces in the lower intestines (Unduka) separate and hence is called Maladhara-kala 17.

Pittadhara-Kala:—

The sixth Kala is called Pittaphara-kala; it holds (the chyme derived from) the four kinds of solid and liquid foods (in the Pitta-sthana or biliary region, propelled from the stomach (Amashaya or Grahani-Nadi) and on its way to the (Pakashaya) intestines (for the proper action of the digestive juices upon it) 18.

Memorable Verse:—The four kinds of food, viz. those that are chewed, swallowed, drunk, or licked, and brought into the intestines (Kostha) of a man, are digested in proper time through the heating agency (action) of the Pitta 19.

Shukradhara-Kala:—

The seventh Kala is called Shukradhara (semen-bearing), which extends throughout the entire body of all living creatures. 20.

Memorable Verse:—The physician should know that like fat (Sarpi) in the milk, or sugar in the expressed juice of sugar cane, the (seat of) semen is coextensive with the whole organism of a man (or animal).

The semen passes through the ducts situated about two fingers’ breadth on either side (vas deferens) and just below the neck of the bladder and finally flows out through the canal. The semen of a man during an act of sexual intercourse with a female under exhilaration comes down from all parts of his body owing to the extreme excitement (engendered by the act). 21-33.

The orifices of the artava—carrying channels (vessels of the uterine mucosa) of a pregnant woman are obstructed by the fetus during pregnancy and hence there is no show of menses (during gestation). The menstrual blood thus obstructed in its downward course ascends upwards; a part of it accumulates and goes to the formation of placenta (Apara), while the rest ascends higher up and reaches the breasts; this is the reason why the breasts of a pregnant woman become full and plump. 24.

The spleen and liver of the fetus are formed out of blood; the lungs are made of the froth of the blood; and the Unduka or fecal receptacle, of the refuge matter (Mala) of the blood. 25.

Metrical Texts:—

The intestines (Antra), the bladder (Vasti), and the anus (Guda) of the fetus are formed out of the essence of the blood and Kapha, baked by the Pitta into which Vayu enters as well. As fire fed by draughts of air refines the dregs of golden ore and transforms it into pure metal, so blood and Kapha acted upon by the heat of the Pitta are transformed into the shape of the intestines etc. in the abdomen. The tongue is made of the essence of the flesh, blood and Kapha. The Vayu, combined with heat (Pitta) in adequate proportion, rends through the internal channels into the flesh and transforms them into muscles (Peshi). The Vayu, by taking offthe oily principles of fat (Meda), transforms them into (Shira) and (fibrous tissues) Snayu, the underbaked (Mridu) ones being converted into the Shira and the overbaked (Kshara) ones into the Snayu. The internal cavities (Ashayas) of the body mark the spots or regions where the Vayu had constantly stayed in its embryo stage. 26-29.

The kidneys (Vrikkas) are made out of the essence of the blood and fat. The testes are formed out of the essence of the blood, flesh, Kapha and fat. The heart is formed out of the essence of blood and Kapha; and the vessels (Dhamanis) carrying the vital principles of the body are attached to it (heart). The spleen and the lungs are situated below and beneath the heart on the left side, and the liver and Kloma (Pancreas?) below and beneath it (heart) on the right. The heart is the special seat of consciousness (Cetana) in all creatures. Sleep sets in when this viscus (heart) of a person becomes enveloped by the effects of the Tamas (principles of illusion or nescience). 30-31.

Memorable Verse:—

The heart which is of the shape of a lotus bud hangs with its apex downward, folding itself up during sleep and expanding with the return of wakening or consciousness. 32.

Sleep and its virtues:—

Sleep is the illusive energy of God (lit.–the all-pervading deity) and naturally has its sway over all created beings. The kind of sleep which sets in when the sensation-carrying channels (Snayu) of the body are choked by Sleshma, which abounds in the quality of Tamas, is known as Tamasi-nidra. It is this sleep which produces unconsciousness at the time of dissolution or death. A man of Tamisika-temperament sleeps both in the day and night; one of the Rajasika-temperament sleeps either in the day or in the night; while sleep never visits the eyelids of a man of Sattvika-temperament before midnight. Persons with enfeebled Kapha and aggravated Vayu, or suffering from bodily and mental troubles, get little sleep, and if at all, their sleep is of the Vaikarika or delirious type (i.e. much disturbed)[2]. 33-34.

Memorable Verses:—

O Sushruta! the heart is said to be the primary seat of consciousness (Cetana) in the animated beings. Sleep overcomes a man whenever the heart is enveloped in the illusive effects of Tamas. Sleep is the offspring of Tamas and it is the quality of Sattvam that brings on awakening. This is the fundamental law of Nature. The self-conscious individuality (Self), ensconced in the material frame of man which is composed of the five material elements, recollects through the agency of the mind (Manah), which abounds in the quality of Rajas, the renaissance of his by-gone existences, and wakens up in his psychic plane the pictures of good or evil deeds done by him therein. Dreams are but the embodiment of these recollections. The self or Jivatma, though he sleeps not himself, is said to be sleeping, whenever the sense organs are overpowered by the illusive energy of Tamas. 35.

Day sleep is forbidden in all seasons of the year, except in summer and in the case of infants, old men, and persons enfeebled by sexual excesses, or in Kshata- kshina diseases and in case of habitual tipplers. A sleep in the day may be enjoyed after the fatigue of a long journey, riding, or physical labour, or on an empty stomach. It may be allowed as well to men suffering from the loss of fat, Kapha or blood, to those of scanty perspiration, or of dry or parched constitution; and also to those who have been suffering from indigestion and who may sleep for a Muhurta (48 minutes) in the day time. Those who have kept late hours in the night may sleep in the day for half the time they have watched in the night (and no more). Day sleep is the outcome of perverted nature and all the Doshas of the body are aggravated by a sleep in the day, bringing on many a troublesome complaints such as cough, asthma, catarrh, heaviness of the body, aching or lassitude in the limbs, fever, loss of appetite etc. On the other hand, the keeping of late hours in the night develops symptoms (Upadrava) which are peculiar to the deranged Vayu and Pitta. 36.

Memorable Verses:—

Hence, one should not sleep in the day, nor keep late hours. Having known both these acts to be injurious, the wise should observe moderation in sleep. A conformity to the preceding rule of conduct is rewarded with health, good humour, strength, healthful complexion, virility and beauty, a frame which is neither too fat nor too thin, and a long life of a hundred years). A day sleep may not prove injurious to those who are habituated to it and conversely keeping late hours at night may not tell upon the health of those to whom it is customary. 37-39.

An aggravated condition of the bodily Vayu or Pitta, an aggrieved state of the mind, loss of vital fluid, and a hurt or an injury may bring on insomnia, the remedy being the adoption of measures antagonistic to those which destroy sleep. The following measures are useful in cases of sleeplessness—such as anointing the body, rubbing of oil on the head, soft massages of the body (with cleansing paste) and shampooing; a diet consisting of cakes and pastry made up of Shali-rice and wheat prepared with sugar or other derivatives of sugarcane, sweet or soothing articles with milk or meat juice or flesh of animals of the Biskira or Vileshaya class, and eating of grapes, sugar and sugar-cane at night, are beneficial (in such cases); so also a soft and pleasant bed, and easy and convenient seats and means of locomotion. Hence, a wise physician should advise those and similar other measures to allay insomnia. 40-41.

Excessive sleep should be remedied by emetics, Sanshodhana measures, fastings, bleeding, and works which tend to disturb the mental equanimity of man. Keeping up at night is beneficial to persons afflicted with obesity, poison or the deranged Kapha; so also a nap in the day is beneficial to people troubled with hiccough, colic pain, dysentery, indigestion, or thirst. 42-43.

Somnolence or Drowsiness etc.:—

In this kind of light sleep, or in the preliminary stage of sleep, the sense organs are overpowered and remain only partially cognisant of their respective objects and all (subjective and objective) symptoms of a sleepy person such as, yawning, sense off atigue (fatigue) and heaviness of the limbs, present themselves in succession; these are the special features of Tandra. One (prolonged) inhaling of the air through a widely open mouth and subsequent exhaling with the contraction of the limbs and tearful eyes are (all together) called Jrimbha or yawning.

A sense of fatigue without any physical labour which comes upon a person unaccompanied by hurried respiration is called Klama. It obstructs the proper functions of the senses as also the workings of the active organs[3] An inordinate love of pleasure and a great aversion to pain, attended with an apathy to ail sorts of work even with the capacity of carrying them through is called Alasyam (laziness). Nausea, without vomiting of ingested food, attended with salivation and formation of sputum, and cardiac distress are the symptoms of Utklesha. A sweet taste in the mouth, drowsiness, a beating pain in the heart, dizziness, and non-relish for food are the signs of Glani (languor). A feeling as if the whole body were wrapped in a wet sheet, accompanied by an extreme heaviness of the heart, is called Gauravam. 44–50.

Loss of consciousness (Murcca) is due to an excess of the deranged Pitta and to the quality of the Tamas; vertigo (Bhrama) is due to an aggravated state of the Vayu, Pitta,and to the quality of the Rajas; drowsiness (Tandra) is due to a similar condition of the Vayu, Kapha and to the quality of the Tamas; while sleep (Nidra) produced by the predominance of Kapha and to the quality of the Tamas in the organism. 51.

The growth of a fetus in the womb is effected by the serum (Rasa) prepared out of the food (assimilated by its mother) incarcerated by the Vayu in the internal passage of its body. 52.

Memorable Verses:—

Be it clearly understood that there exists fire or heat (Jyoti) in the umbilical region of the fetus which is fanned by its bodily Vayu and thus contributes to the growth of its body. The same Vayu in combination with the heat (thus generated), expands the upward, downward, and lateral channels (in the body of the embryo) and thus leads to the growth of the fetus. The eyes (Dristi —aperture of sight) and the hair-follicles of a man do not participate at all (in the general expansion of the body). This is a law of nature, and is the opinion of Dhanvantari. On the other hand the growth of hair and finger nails continue even when the body enters the stage of decay. This also is a law of nature. 53–56.

The Temperaments:—

The temperaments (Prakriti) of persons may be of seven different types, according as the deranged Doshas of the body are involved therein, either severally, or in combination of two or of all the three together. The temperament (Prakriti) of a man is determined by the preponderance of the particular Doshas at the time of his generation (actual combination of the semen and ovum) and is marked by that preponderant Dosha. The characteristics of the different Prakritis are now described. 57-58.

Vataja-Temperament:—

A man of Vatika- temparament is wakeful, averse to bathing and cold contact, unshapely, thievish, vain, dishonest and fond of music; the soles of his feet, and the palms of his hands are much fissured; has often a rough and grisly beard and moustache, finger nails and hairs in him; he is hot-tempered and is given to biting his finger nails and grinding his teeth (when asleep). Morally he is impulsive, unsteady in his friendship, ungrateful, lean, and rough; his body is marked with a large number of prominent veins (Dhamani); he is incoherent in his habit and vacillating in his temper. He is a fast walker and dreams of scaling the skies in his sleep. His eyes are always moving. His mind is never steady. He makes few friends, is capable of accumulating very little money and talks incoherently. The traits of his character etc. seem to resemble those of a goat, jackal, hare, mouse, camel, dog, vulture, crow, and of an ass. 59-60.

Pittvaja-Temperament:—

A man of Pittvaja temperament perspires copiously emitting a fetid smell. His limbs are loosely shaped and yellowish in colour. The finger nails, eyes, palate, tongue, lips, soles and palms of such a person are copper-coloured. He looks ugly with wrinkles, baldness and grey hair; he eats much, is averse to warmth and irritable in temper, though he cools down very soon. He is a man of middling strength and lives up to middle age. He is intelligent and possesses a good retentive memory and loves to monopolise the conversation (by pulling down any speaker that may be present). He is vigorous and is simply irresistible in battle. He dreams in his sleep of such things as meteors, lightning-flashes, fire, Nageshvara, Palasha or Karnikara plants. He is never overpowered with fear nor bends before a powerful antagonist; he protects the suppliant and is very often afflicted with suppuration in the cavity of the mouth. The traits of his character resemble those of a serpent, an owl, a Gandharba (heavenly musician), Yaksha, cat, monkey, tiger, bear, and of a mongoose. 61-64.

Kaphaja Temperament:—

The complexion of a man of Shleshma temperament resembles either the colour of a blade of grass, blue lotus, polished sword, wet Arishta, or that of the stem of the Sara grass. He is comely in appearance, fond of sweet tastes, grateful, self-controlled, forbearing, unselfish and strong; he does not hastily form any opinion, and is fast in his enmity. His eyes are white; his hair curly and raven black. He is prosperous in life. His voice resembles the rumblings of a rain-cloud, the roar of a lion, or the sound of a Mridanga. He dreams in his sleep of large lakes or pools decked with myriads of full blown lotus flowers, swans and Chakravakas. His eyes are slightly red towards the comers, the limbs are proportionate and symmetrically developed with a cool effulgence radiating from them He is possessed of the qualities of the Sattvika stamp, capable of sustaining pain and fatigue and respectful towards his superiors He possesses faith in the Shastras and is unflinching and unchanging in his friendship; he suffers no vicissitudes of fortune, makes large gifts after long deliberation, is true to his word and always obedient to his preceptors. The traits of his character resemble those of Brahma, Rudra, Indra, Varuna, a lion, horse, an elephant, cow, bull, an eagle, swan and of the lower animals. 65-68.

A combination of two different temperaments should be called a double temperament or a Dvandaja one; and one of all the three temperaments in a person should be stated as a Sannipatika one. 69.

The temperament of a man is never altered, nor does it suffer any deterioration or abatement. A change, abatement or deterioration in any particular case should be regarded as the harbinger of death. As a worm, bred in poison, is not troubled with it, so the temperament of a person however painful to others does no inconvenience to himself. Several authorities hold that the temperaments of persons have their origin in the material elements of the body and accordingly they classify them as the Vatika Prakriti, the Taijasa Prakriti, and the apya (watery) Prakriti, the characteristic traits of which respectively correspond to the first three temperaments described above. 70–71.

A man of the Parthiva temperament is large in his stature, and is firm, strong and muscular in his limbs. A man of the Nabhasa temperament is pious and long-lived, has large aural cavities. The mental temperaments are classified according to their qualities. 72.

Sattvika Features:—

The features of a Brahma-kaya person are cleanliness of person and conduct, belief in the existence of God, a constant reader of the Vedas, a worship and reverence of elders and preceptors, hospitality and celebration of religious sacrifices. Those of a Mahendra-kaya person are valour, command, constant discussion of the Shastras, maintenance of servants and dependents and magnanimity. The features of a Karuna-kaya person are a liking for exposure to cold, forbearance, a brown hue of the pupils, golden colour of the hair and sweet speech. The features of a Kouvera-kaya person are, arbitration of disputes, capacity of bearing hardships, earning and accumulation of wealth, and capacity of propagation or fertility. The features of a Gandharva-kaya person are love of garlands and perfumes, fondness of songs and music, and love making. The features of a Yamya- Sattva person are sense of duty, promptness, firmness of action, courage, memory, purity, and absence of anger, illusion, fear and malice. The features of a Rishi-Sattva man are divine contemplation, observance of vows, complete sexual abstinence, performance of Homas, celebration of religious sacrifices, knowledge, wisdom and cultivation of divine or spiritual science. These seven types of men should be considered as belonging to the Sattvika group (of Sattvika mental temperament). Now hear me describe the features of men of Rajasika stamp (of mind). 73.

Rajasika Features:—

Asura-Sattva men are affluent in circumstances, dreadful, valorous, irascible, jealous of other men’s excellence, gluttonous and fond of eating alone without sharing with any one else. A Sarpa-Sattva man is irritable, laborious, cowardly, angry, double-dealing, and hasty in eating and sexual intercourse. A Shakuna-Sattva man is gluttonous, intemperate in sexual matters, irritable and fickle. A Rakshasa-Sattva man is solitary in his habits, fierce, jealous of others excellence, externally pious, extremely vain and ignorant. The characteristics of a Paishacha- Sattva man are eating food partaken of by another, irritability of temper, rashness, shamelessness, and covetousness of female possessions. Those of Preta-Sattva man are utter want of knowledge as regards duty, laziness, miserableness, envy, covetousness, niggardliness. These six belong to the Rajasika cast of mind. Now hear me describe the characteristic traits of men of the Tamasika temperaments. 74.

Tamasika Features:—

The features of a Pashava-Sattva man are perverseness of intellect, parsimoniousness, frequent sexual dreams and incapacity of ascertaining or discerning anything. The features of Matsya-Sattva man are unsteadiness, stupidity, cowardice, fond of intermissive quarrel and oppression and a longing for water. The features of a Vanaspati-Sattva man are fondness of staying at the same place, constant eating and absence of truthfulness, piety, riches and enjoyment. Thus the three types of Tamasika temperament have been described, A physician should take in hand a patient with an eye towards these mental traits etc. A physician should coolly deliberate upon the different types of temperament described herein and their characteristic features. 75-76.

Thus ends the fourth Chapter of the Sharira Sthana in the Shushruta Samhita which treats of fetal development etc.

Footnotes and references:

The complexion of a person is due to this first layer; and as the colour of an opaque body is due to the rays that are reflected from its surface, this layer is rightly named Avabhasini or reflecting layer.

The text runs “Vriherashtadashabhaga,” which means eighteen (or so many) parts of a Vrihi; and Dalian comments that “Vrihi” stands for a measure equal to the twentieth division of a Vrihi or rice grain.